FADESIRE O AJUWON


Address: 4218 S King Dr, 1n, Chicago, IL 60653
Phone: 7087055841

FADESIRE O AJUWON (NPI# 1598202897) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1598202897
Entity Type Individual
Full Name FADESIRE O AJUWON
Credential APN
Practice Address 4218 S King Dr
1n
Chicago
IL 60653
Mailing Address 355 E Erie St
Chicago
IL 60611-3167
Practice Telephone 7087055841
Practice Fax Number 7737512250
Mailing Telephone 3122381000
Enumeration Date 2017-01-24
Last Update Date 2018-06-20
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 163W00000X Registered Nurse 209014405 IL Nursing Service Providers
Y 363L00000X Nurse Practitioner 209-014405 IL Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
4218 S King Dr, 1n, Chicago, IL 606533298 7087055841 7737512250

Office Location

Street Address 4218 S KING DR
1N
City CHICAGO
State IL
Zip Code 60653

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1881215804 Pamela Ann Brazelton-sykes Counselor Pioneer Gardens Supportive Living, 3800 S King Dr, Chicago, IL 60653 2020-04-30
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1245758309 Qi Wellness LLC Case Management 525 E 46th Place, Chicago, IL 60653 2017-09-08
1013464619 Roundys Supermarkets Inc Pharmacy 3857 S Dr Martin Luther King Jr Dr, Chicago, IL 60653 2016-09-01
1417384793 Griffin Orthodontics PC Dentist 1040 E 47th Street, Chicago, IL 60653 2013-10-02
1114350659 Carita Dale Johnson Pharmacist 3753 S. Cottage Grove Ave, 104, Chicago, IL 60653 2013-08-20
1245677848 Mercy Diagnostic and Treatment Center Clinic/Center 3755 S Cottage Grove, Chicago, IL 60653 2013-05-23
1952745937 Mercy Community Pharmacy At Oakwood Shores Pharmacy 3753 S. Cottage Grove, Chicago, IL 60653 2013-04-22
1386952315 Jami S Little Developmental Therapist 617 East 41st, Chicago, IL 60653 2010-09-24
1992017610 Frances Sue Ratcliff Social Worker 4314 S. Cottage Grove Ave, Chicago, IL 60653 2010-07-10
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Taxonomy Information

Taxonomy Code 363L00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner

Taxonomy Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1477151272 Yolanda K Bradford Nurse Practitioner 2700 S California Ave, Chicago, IL 60608-5108 2020-10-14
1073125431 Faith M Langtiw Nurse Practitioner 2704 W Catalpa Ave, Chicago, IL 60625-3216 2020-08-18
1871114025 Quickcare, Pllc Nurse Practitioner 6419 W Touhy Ave Apt 4a, Chicago, IL 60646-1040 2020-04-29
1376170894 Julia Jekli Nurse Practitioner 365 N Halsted St Apt 3009, Chicago, IL 60661-1379 2020-03-25
1821623281 Rina Delapena Nurse Practitioner 5630 N Sheridan Rd Apt 319, Chicago, IL 60660-4810 2020-03-06
1902439193 Iwona Boska Nurse Practitioner 676 N St.clair Street, Suite 2140, Chicago, IL 60611 2020-02-17
1962032813 Sonia Ivelis Fernandez Nurse Practitioner 6129 N Campbell Ave Apt 1, Chicago, IL 60659-2809 2020-01-20
1164060257 Julie Ann Daniels Nurse Practitioner 5808 W Eddy St, Chicago, IL 60634-4351 2019-12-19
1720625593 Bogdana Gryniv Nurse Practitioner 5758 S Maryland Ave Ste 5a, Chicago, IL 60637-1426 2019-11-29
1023669835 Carlette Bailey Nurse Practitioner 6700 S Oglesby Ave Apt 1204, Chicago, IL 60649-1373 2019-09-23
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Competitor

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City CHICAGO
Zip Code 60653

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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